ILYA FATAKHOV (Credential# 1416813) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
ILYA FATAKHOV is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.056588. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 71-11 Yellowstone Blvd Apt. # 2p, Forest Hills, NY 11375-5202. The current status is active.
Licensee Name | ILYA FATAKHOV |
Credential ID | 1416813 |
Credential Number | 1.056588 |
Credential Type | Physician/Surgeon |
Business Address |
71-11 Yellowstone Blvd Apt. # 2p Forest Hills NY 11375-5202 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2017-06-23 |
Effective Date | 2020-05-01 |
Expiration Date | 2021-04-30 |
Refresh Date | 2020-04-22 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1270858 | CSP.0059664 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-08-26 | 2019-03-01 - 2021-02-28 | ACTIVE |
1434099 | CSP.0066063 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-06-28 | 2017-06-28 - 2019-02-28 | LAPSED |
Street Address | 71-11 Yellowstone blvd Apt. # 2P |
City | FOREST HILLS |
State | NY |
Zip Code | 11375-5202 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Berta Shchegol | 110-24 67th Drive, Forest Hills, NY 11375 | Dentist | ~ |
Lawrence M Rosenbloom | 110-11 Queens Blvd., Forest Hills, NY 11375 | Architect | 2020-08-01 ~ 2021-07-31 |
Beatrice E Hunt | 43 Exeter St, Forest Hills, NY 11375 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Elena Chachik | 108-25 72 Ave 3b, Forest Hills, NY 11375 | Dentist | 2020-06-10 ~ 2021-03-31 |
Lina F Spartos | 99-15 Ascan Ave., Forest Hills, NY 11375 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Isabella Mihaelson | 100-10 67th Rd #4-g, Forest Hills, NY 11375 | Certified General Real Estate Appraiser | 2020-05-01 ~ 2021-04-30 |
Co B Quang | 102-30 66th Road #3a, Forest Hills, NY 11375 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
Benjamin V Katayev · Vladislav | 110-35 67 Drive, Forest Hills, NY 11375 | Dentist | 2020-06-01 ~ 2021-05-31 |
Yulian Aminov | 112-11 69th Avenue, Forest Hill, NY 11375 | Dentist | 2020-04-01 ~ 2021-03-31 |
Laura Marilyn Soriano | 7714 113th St, Forest Hills, NY 11375 | Professional Counselor | 2020-04-01 ~ 2021-03-31 |
Find all Licenses in zip 11375 |
City | FOREST HILLS |
Zip Code | 11375 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + FOREST HILLS |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Ilya Michael Averbuch | Po Box 11535, Philadelphia, PA 19116-0535 | Physician/surgeon | 1991-05-24 ~ 1992-03-31 |
Ilya Lim | 1625 Straits Turnpike, Middlebury, CT 06762 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Ilya Blokh Md | 2483 W16th St Apt 8g, Brooklyn, NY 11214 | Physician/surgeon | 2006-07-07 ~ 2007-08-31 |
Ilya Miloslavskiy | 313 6th Ave Apt 1a, New York, NY 10014-4445 | Dentist | 2013-06-03 ~ 2014-06-30 |
Ilya I Garibyan | 55 W 69th St Apt 3a, New York, NY 10023-4723 | Dentist | 2014-05-30 ~ 2015-04-30 |
Ilya Sapozhnik | 49 Bokee Ct Apt 3a, Brooklyn, NY 11223-6166 | Dentist | 2016-04-19 ~ 2016-11-30 |
Ilya Kholodenko | 31 Brook Way, Demarest, NJ 07627 | Professional Engineer | 2004-05-11 ~ 2005-01-31 |
Ilya Khaimov | 14758 78th Ave, Flushing, NY 11367-3433 | Barber | 2020-05-01 ~ 2022-04-30 |
Ilya V Melnikov | 175 Plymouth St, New Haven, CT 06519-2511 | Massage Therapist | 2015-04-29 ~ 2017-01-31 |
Ilya Smolenskiy | 586 Grand St. #2b, Brooklyn, NY 11211 | Wholesaler Salesman | 2017-02-01 ~ 2019-01-31 |
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Data Provider | Connecticut Department of Consumer Protection |
Jurisdiction | Connecticut |
Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).